Femoral osteochondral fracture--a non-contact injury in martial arts? A case report.

Mbubaegbu, Chima; Percy, A J

doi:10.1136/bjsm.28.3.203

Cited by 13 publications

(5 citation statements)

References 3 publications

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“…Internal fixation of an osteochondral fragment presents a challenge in terms of obtaining anatomic reduction, fixation, and adequate compression for healing. Fixation with countersunk mini‐cancellous and Herbert screws [51], bioabsorbable screws [49] and pins [17], suture bridges [11], and glue tissue adhesive [20] have been reported with varying results. Arthroscopically assisted procedures allow a relatively easy retrieval of a displaced fragment and a careful assessment of the subchondral bone in the defect, the integrity of the cartilage of the osteochondral fragment and the detection of accompanying lesions, such as of the patellar surface.…”

Section: Traumatic Osteochondral Defectsmentioning

confidence: 99%

Disease-specific clinical problems associated with the subchondral bone

Pape

Filardo

Kon

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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The subchondral bone is involved in a variety of diseases affecting both the articular cartilage and bone. Osteochondral defects in distinct locations and of variable sizes are the final results of different etiologies. These include traumatic osteochondral defects, osteochondritis dissecans, osteonecrosis, and osteoarthritis. Traumatic osteochondral defects are caused by osteochondral fractures, separating an osteochondral fragment that includes articular cartilage and both subchondral and trabecular bone from the joint surface. In osteochondritis dissecans, the disease originates in the subchondral bone and secondarily affects the articular cartilage. Location, stage, size, and depth of osteochondral lesions play a role in the treatment of traumatic osteochondral defects and osteochondritis dissecans. Surgical options include fragment refixation, transplantation of osteochondral autografts, or bone restoration by impacted cancellous bone grafts combined with autologous chondrocyte transplantation. An insufficiency fracture of the subchondral bone may be the initiating factor of what was formerly believed to be a spontaneous osteonecrosis of the knee (SPONK). Recent histopathological studies suggest that each stage of SPONK reflects different types of bone repair reactions following a fracture of the subchondral bone plate. Osteoarthritis is a disease that does affect not only the articular cartilage, but also the subchondral bone. Reconstructive surgical techniques aim at preserving joint function, inducing fibrocartilaginous repair, and at correcting malalignment. This review summarizes the current status of the clinical treatment of traumatic osteochondral defects, osteochondritis dissecans, osteonecrosis, and osteoarthritis as they affect the subchondral bone region and its adjacent structures.

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Section: Traumatic Osteochondral Defectsmentioning

confidence: 99%

Disease-specific clinical problems associated with the subchondral bone

Pape

Filardo

Kon

et al. 2010

Knee Surg Sports Traumatol Arthrosc

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“…To our knowledge the diagnosis and successful treatment of an unstable (flapping) osteochondral flake of the lateral femoral condyle causing cystic alterations of the underlying bone has not been described before (Cain and Clancy 2001;Biau and Schranz 2005;Mashoof, Scholl et al 2005;Mbubaegbu and Percy 1994;Schillians, Baltzer et al 2001;Strauss, Nelson et al 1984;Taitsman, Frank et al 2006). The mechanism of injury is probably similar to that in a Hoffa or Busch fracture (isolated tangential fracture of the dorsal part of the femoral condylus) ( ).…”

Section: Discussionmentioning

confidence: 94%

Annual Meeting, Vereinigung für Kinderorthopädie (Paediatric Orthopaedic Society of Germany, Austria, Switzerland) Düsseldorf 2007

2008

Journal of Children's Orthopaedics

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BackgroundIn 2004 J. A. Herring published a multicenter study in which he presented his latest results of predictive risk factors in Legg-Calvé-Perthes disease. As we are attending a lot of children with LeggCalvé-Perthes disease, we reviewed our data of the last 20 years for children we have treated by a femoral varus osteotomy and compared the results. Method Since 1986 we attended 139 patients with Legg-Calvé-Perthes disease in our department. Fifty-six patients who were just treated by a femoral varus osteotomy and which had a clinical and radiological mean follow up of 8.3 years (2.1-28.6) had been included for this study. This number of patients is equivalent to 62 hips. The aspect ratio (left-right) was equal, the sex-ratio boy/girl was 4.7/1. The mean age of diagnosis was 6.1 years (1.9-12.5) and operation was done about 7 months later. The mean follow-up time was more than 8 years with 26 hips followed up for more than 8 years. We reevaluated the X-rays of our patients with Herring and Catteral classification and measured the lateral subluxation. The outcome was evaluated at latest follow-up exam with Mose and Stulberg classification and the lateral subluxation once again measured. Results With our study we were able to confirm the results of J. A. Herring: a preoperative high grading in Herring or Catteral classification is often associated with poor results in Mose or Stulberg classification. An age of more than 8 years at initial diagnosis correlates also with bad results. Female hips are above average represented in poorer grading of Mose and Stulberg classification, which might be due to their nonretarded skeletal age. The lateral subluxation, which was not considered in J. A. Herring's multicenter study is used in our department as substantial operation criteria. Our data demonstrates the evolution of a re-subluxation after operation in dependence of preoperative Catteral classification.

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“…Presumably the edges of the reconstruction occur by fibrocartilage connection to adjacent normal cartilage; however, we have no good method to assess such repair. Screw or pin fixation has been described for fixation of these lesions [3,7,16,18,20,35]. The advantage of using specially designed chondral darts or pins is that they are bioabsorbable and allow postoperative MRI without the need for implant removal.…”

Section: Discussionmentioning

confidence: 99%

“…Arthroscopically assisted procedures allow documentation of concomitant injury and direct observation of articular reduction with minimal trauma to the local soft tissues. Successful fixation with subsequent healing of lateral femoral condyle osteochondral fragments has been reported with the use of countersunk intraarticular screws [35], Herbert screws [16,20], and bioabsorbable screws [18] and pins [3,7]. Fixation of the rare traumatic Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.…”

Section: Introductionmentioning

confidence: 97%